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You cannot drive reforms without the goodwill of nurses

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This week an investigation by Nursing Times found that a third of the new GP consortia being set up across the country to effectively run the NHS from local level have decided to include a nurse on their board.

It could be argued that a third is actually quite a good start and that many GPs are rightly recognising the important role nurses can play at the top table, without the need for a diktat to do so from ministers – not that there is one at the moment.

Giving nurses a seat on the board may be a token gesture to begin with, but better that than no gesture at all

But equally, that still leaves two thirds where the group about to start making key decisions for the local health economy is not formally acknowledging input from the professional group that provides the majority of the care.

There has, at least, been a marked increase in focus on this important issue. Just a few months ago the message from ministers was that GPs would run the consortia, with advice from other professions where requested. When challenged on it, there would usually be a few warm words about other clinicians but little substance behind it.   

Then came the report from the influential Commons health select committee recommending a seat on the board for nurses, hospital doctors and a range of other interested parties.

Then came the announcement of the government’s “pause” to reflect and listen to people’s concerns about its NHS reforms, sparked by realisation from No 10 that all was not well.

Then came the public “rebuke” dished out by the RCN Congress to health secretary Andrew Lansley over his failure to be more inclusive of the nursing profession in his reforms, at which he said: “We need to move from a top down management structure to a front line led clinical leadership and nurse leadership culture. If I’ve not got that across I apologise.”

One of the best ways for Mr Lansley to “get that across” would be to instruct consortia to have a nurse on the board.

Mr Lansley told a nursing conference in March that requiring consortia to have a nurse on their board would be “tokenistic”. As reported by Nursing Times elsewhere in this newsletter, this point has also been made by consortia and the GP leading the government’s listening exercise. 

Yes, giving nurses a seat on the board may be a token gesture to begin with, but better that than no gesture at all.

Yes, it will require some careful use of political machinery and a fundamental shift in the ideology behind consortia – but the political landscape has changed. The government is no longer sitting as comfortably as it was two months ago.

A gesture, however token it may appear, is required. It can be built on.

As every child knows, you cannot start to drive a fairground dodgem without a token. Likewise, you cannot hope to drive reforms in the NHS without the goodwill of nurses.

Please support Nursing Times’ “Seat on the Board” campaign by signing an online petition to Mr Lansley.

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